Nizatidine


Specific H2 receptor antagonist, belonging to the group of imidazole derivatives. Used in the treatment of gastric and duodenal ulcers, gastroesophageal reflux and hypersecretory states.
 
Incidence
One case reported.
 
Clinical manifestations
General: anaphylactic shock
 
Respiratory: dyspnea, laryngeal stridor.
 
Cutaneous: urticaria, angioedema of lips and tongue.
 
Diagnostic methods
Cutaneous testing.
 
Skin prick-tests: 10 mg/ ml: negative.
 
Intradermal skin tests: positive at 1/10000 to 1/1000.
 
Oral challenge test.
 
Mechanisms
IgE-mediated hypersensitivity (positive skin tests, positive oral challenge).
 
Management
No cross-reactivity found with other anti H2 drugs (oral challenge).

References

  1. Mira-Perceval J.L, Ortiz J.L, Sarrio F, Miralles J.C, Hernandez J, Negro-Alvarez J.M, Lopez-Sanchez J.D, Garcia-Selles F.J, Pagan J.A, "Nizatidine anaphylaxis", J. Allergy. Clin. Immunol., 1996; 97: 855 - 6

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.